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Eleventh Circuit affirms trial court's summary judgment for correctional center in Section 1983 civil rights case, finding no deliberate indifference to plaintiff's medical needs

On May 9, 2017, in Dang v. Sheriff, Seminole County, No. 15-14842, the Eleventh Circuit Court of Appeals affirmed the trial court’s summary judgment for a correctional facility in a Section 1983 civil rights case, finding that there had been no deliberate indifference by the facility’s medical staff to the plaintiff’s medical needs. In Dang, the pretrial detainee at the Seminole County Jail had contracted meningitis that went undiagnosed for a considerable period of time although he had numerous interactions with medical staff.

Quoting Harlow v. Fitzgerald, 457 U.S. 800, 818 (1982), the Eleventh Circuit observed that qualified immunity protects government officials if “their conduct does not violate clearly established statutory or constitutional rights of which a reasonable person would have known.” Quoting Lee v. Ferraro, 284 F.3d 1188, 1194 (11th Cir. 2002), the Court additionally observed that “[t]he purpose of this immunity is to allow government officials to carry out their discretionary duties without the fear of personal liability or harassing litigation, protecting from suit all but the plainly incompetent or one who is knowingly violating the federal law.”

The Court observed that a public official who wishes to avail himself of qualified immunity must first prove that he was acting within the scope of his discretionary authority when the allegedly wrongful acts occurred. The Court quoted Rich v. Dollar, 841 F.2d 1558, 1564 (11th Cir. 1988) for the principle that an official acts within his discretionary authority if his actions (1) were undertaken “pursuant to the performance of his duties,” and (2) were “within the scope of his authority.” Seealso Holloman v. Harland, 370 F.3d 1252, 1265 (11th Cir. 2004) (noting that an official acts within his discretionary authority if he “perform[s] a legitimate job-related function . . . through means that [are] within his power to utilize”).

The Court concluded that the medical staff at the correctional facility had been acting within the course and scope of their discretionary authority when they treated the plaintiff, so the burden shifted to the plaintiff to show that that qualified immunity was nevertheless inappropriate because he was deprived of an actual constitutional right that was clearly established at the time of the violation. Since he was a pretrial detainee rather than a convicted prisoner, the plaintiff had alleged a violation of his rights under the Fourteenth Amendment rather than the Eighth Amendment, although the same standard was determined to apply in both cases, namely, that he was required to show (1) a serious medical need; (2) the health care providers’ deliberate indifference to that need; and (3) causation between the health care providers’ indifference and the plaintiff’s injury.

To establish deliberate indifference, the Court observed that the plaintiff was required to prove (1) subjective knowledge of a risk of serious harm; and (2) disregard of that risk (3) by conduct that is more than mere negligence. The Court quoted Caldwell v. Warden, FCI Talladega, 748 F.3d 1090, 1099–1100 (11th Cir. 2014) for the principle that subjective knowledge of the risk requires that the defendant be “aware of facts from which the inference could be drawn that a substantial risk of serious harm exists, and he must also draw the inference.” Quoting Burnette v. Taylor, 533 F.3d 1325, 1331 (11th Cir. 2008), the Court additionally observed that “imputed or collective knowledge cannot serve as the basis for a claim of deliberate indifference. Each individual defendant must be judged separately and on the basis of what that person kn[ew].”

The Court stated that an official disregards a serious risk by more than mere negligence “when he [or she] knows that an inmate is in serious need of medical care, but he [or she] fails or refuses to obtain medical treatment for the inmate.” Quoting Lancaster v. Monroe Cty., Ala., 116 F.3d 1419, 1425 (11th Cir. 1997), overruled on other grounds by LeFrere v. Quezada, 588 F.3d 1317, 1318 (11th Cir. 2009). The further observed that even when medical care is ultimately provided, a prison official may nonetheless act with deliberate indifference by delaying the treatment of serious medical needs. See Harris v. Coweta Cty., 21 F.3d 388, 393–94 (11th Cir. 1994) (citing Brown v. Hughes, 894 F.2d 1533, 1537–39 (11th Cir. 1990)). Further, “medical care which is so cursory as to amount to no treatment at all may amount to deliberate indifference.” Quoting Mandel v. Doe, 888 F.2d 783, 789 (11th Cir. 1989).. However, medical treatment violates the Constitution only when it is “so grossly incompetent, inadequate, or excessive as to shock the conscience or to be intolerable to fundamental fairness.” Quoting Rogers v. Evans, 792 F.2d 1052, 1058 (11th Cir. 1986). Citing Andujar v. Rodriguez, 486 F.3d 1199, 1204 n.5 (11th Cir. 2007), the Court noted that a violation of Jail policy does not in itself rise to the level of deliberate indifference.